Years of Life Lost (YLLs) due to drug-related deaths in the Islamic Republic Of Iran (2014-2017): a temporal and geographic pattern / Anos de Vida Perdidos (AVP) devido a mortes relacionadas a drogas na República Islâmica do Irã (2014-2017): um padrão temporal e geográfico

Abstract The present study aimed to measure the mortality burden caused by premature death due to substance abuse in different geographical regions of Iran from 2014-17. In this serial cross-sectional study, the data related to individuals who had died of drug abuse were first collected from two sources (Iranian Ministry of Health and Medical Education and the Iranian Legal Medicine Organization). Then, using the capture-recapture method, the number of drug-related deaths was estimated. The years of life lost (YLLs) for all provinces of Iran was calculated based on age, sex, and year. During these four years, the total number of deaths was 12029. The mean age of the individuals was 37.3±14.1. The mean age of dead people was constant in women and men over this period; however, the mean age of dead women due to substance abuse was lower than that of men. The mean YLLs per dead person was 70131.3329 years for men and 9321.1125 years for women. The potential years of life lost (YLLs) showed an upward trend, which was stronger in women than men. It is necessary to perform more regional overviews for finding differences in the number of YLLs due to substance abuse so that specific regional policies can be adopted.

Resumo O presente estudo teve como objetivo medir a carga de mortalidade causada por morte prematura por abuso de substâncias em diferentes regiões do Irã de 2014-17. Neste estudo transversal serial, os dados relacionados aos indivíduos que morreram por abuso de drogas foram coletados primeiramente em duas fontes (Ministério da Saúde e Educação Médica do Irã e Organização de Medicina Legal do Irã). Em seguida, usando o método de captura-recaptura, estimou-se o número de mortes relacionadas a drogas. Os anos de vida perdidos (AVP) para todas as províncias do Irã foram calculados com base na idade, sexo e ano. Durante quatro anos, o número total de óbitos foi de 12029. A média de idade dos indivíduos foi de 37,3±14,1. A média de idade dos mortos foi constante em mulheres e homens ao longo desse período; entretanto, a média de idade das mulheres mortas por abuso de substâncias foi menor do que a dos homens. O AVP médio por pessoa morta foi de 70131,3329 anos para homens e 9321,1125 anos para mulheres. Os anos potenciais de vida perdidos (APVP) apresentaram tendência ascendente, sendo mais forte nas mulheres do que nos homens. É necessário realizar mais análises regionais para encontrar diferenças no número de AVP devido ao abuso de substâncias.

Relationship of cortisol, norepinephrine, and epinephrine levels with war-induced posttraumatic stress disorder in fathers and their offspring

Objective: To compare afternoon serum/plasma levels of hormones in four groups: (A) veterans with posttraumatic stress disorder (PTSD), (B) offspring of PTSD veterans, (C) veterans without PTSD, and (D) offspring of non-PTSD veterans. Methods: Evaluation consisted of a semi-structured interview for axis I and II diagnoses, followed by measurement of afternoon serum cortisol and plasma epinephrine and norepinephrine by ELISA (Diametra) and LND (LDN Labor Diagnostika Nord GmbH & Co. KG) respectively. Data were analyzed using descriptive statistics and the Student t, Kolmogorov-Smirnov, and nonparametric Mann-Whitney tests. Results: One hundred and sixty-eight volunteers were investigated across the four groups. The groups were similar in terms of demographic characteristics, war experience and traumatization, and psychiatric and medical conditions other than PTSD (group A was similar to group C and group B was similar to group D). Between-groups comparisons did not yield statistically significant differences. Post-hoc analyses revealed significant differences in afternoon cortisol level between the offspring of veterans with current/past history of PTSD and the offspring of veterans without a history of PTSD. Conclusion: We only found decreased cortisol levels in offspring of veterans after rearranging the groups to reflect previous history of PTSD. Further studies are required to investigate the relationship between cortisol levels and the transgenerational effects of trauma and parental PTSD. .

A review on the evidence of transgenerational transmission of posttraumatic stress disorder vulnerability

Objective: To understand the risks of posttraumatic stress disorder (PTSD) development in the next generation of PTSD patients, we conducted a review on the biological, but not genetic, evidence of transgenerational transmission of PTSD vulnerability. Methods: Pertinent articles published from 1985 to September 2011 were searched using online academic search engines, including MEDLINE, EMBASE, ScienceDirect, OVID, PsycLIT, and SCOPUS, and a non-systematic review was conducted. Results: There is paradoxical evidence that hypothalamic-pituitary-adrenal axis changes in PTSD patients may also be evident in their offspring. This effect and biological vulnerability to PTSD may be transmitted across generations through maternal epigenetic programming during pregnancy. The samples of most studies, which were not large enough and represented the outcome of few research groups, consisted of a specific type of patients with a particular trauma. Conclusions: There is still a need to conduct studies in other geographical areas with different genetic background and larger samples considering different types of trauma other than those specified in the current literature, so as to strengthen the evidence of transgenerational transmission of PTSD vulnerability. .